Alvarenga-Filho Hélcio, Salles Marisa, Hygino Joana, Ferreira Thais B, Sacramento Priscila M, Monteiro Clarice, Vasconcelos Claudia Cristina F, Alvarenga Regina Maria Papais, Bento Cleonice A M
Department of Neurology, Federal University of the State of Rio de Janeiro, Brazil.
Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil.
J Neuroimmunol. 2017 Feb 15;303:81-89. doi: 10.1016/j.jneuroim.2016.12.013. Epub 2016 Dec 30.
Fatigue is a common "ghost" symptom in patients with multiple sclerosis (MS), an autoimmune disease mediated by T cells that target myelin antigens of the central nervous system. As fatigue has been associated with inflammatory states, its occurrence may negatively impact MS progression. The aim of this study was to evaluate the impact of fatigue on the cytokine profile of patients with relapsing-remitting (RR) MS. For our study, blood were collected from MS patients in clinical remission phase with (n=15) and without (n=15) fatigue. Cytokines were detected by ELISA in the plasma and supernatant collected from anti-CD3/anti-CD28-activated T cells or LPS-stimulated monocytes. In some wells, different doses of hydrocortisone (HC) were added at the beginning of the culture. Here, peripheral levels of IL-6 and TNF-α, as well as in vitro production of cytokines related to Th17 (IL-6, IL-17, IL-22, and GM-CSF) or Th1 (IFN-γ) phenotypes, were elevated in fatigued patients and their levels were associated with fatigue severity. The same phenomenon was observed between the production of IL-6, TNF-α, IL-1β, and IL-23 by monocytes and fatigue. Moreover, HC was less efficient in inhibiting in vitro inflammatory cytokine production in patients with fatigue, mainly those produced by both CD8 T cells and monocytes. Our data, although preliminary, suggests that the occurrence of fatigue, by favoring the in vitro production of Th1/Th17-related cytokines and corticoid resistance, may negatively impact the course of MS.
疲劳是多发性硬化症(MS)患者常见的“幽灵”症状,MS是一种由靶向中枢神经系统髓鞘抗原的T细胞介导的自身免疫性疾病。由于疲劳与炎症状态相关,其出现可能会对MS的进展产生负面影响。本研究的目的是评估疲劳对复发缓解型(RR)MS患者细胞因子谱的影响。在我们的研究中,从临床缓解期伴有疲劳(n = 15)和不伴有疲劳(n = 15)的MS患者中采集血液。通过ELISA检测从抗CD3/抗CD28激活的T细胞或LPS刺激的单核细胞中收集的血浆和上清液中的细胞因子。在一些孔中,在培养开始时加入不同剂量的氢化可的松(HC)。在此,疲劳患者外周血中IL-6和TNF-α水平以及与Th17(IL-6、IL-17、IL-22和GM-CSF)或Th1(IFN-γ)表型相关的细胞因子的体外产生均升高,且其水平与疲劳严重程度相关。单核细胞产生IL-6、TNF-α、IL-1β和IL-23与疲劳之间也观察到相同现象。此外,HC对疲劳患者体外炎症细胞因子产生的抑制作用较弱,主要是对CD8 T细胞和单核细胞产生的细胞因子。我们的数据虽然是初步的,但表明疲劳的发生通过促进Th1/Th17相关细胞因子的体外产生和皮质激素抵抗,可能会对MS的病程产生负面影响。